NPIMap

Organization Active NPI

Magnolia Autism Therapy

  • Community/Behavioral Health Agency
  • Seattle, WA
National Provider Identifier
1730571142
Registry record updated Feb 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
CG60506476 Issued in WA
Legal business name
MAGNOLIA AUTISM THERAPY
Practice address
3214 W McGraw St
Ste 212
Seattle, WA 98199-3239
Phone
(206) 453-4882
NPI assigned
Feb 21, 2015
Last updated
Feb 21, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
McCullough Campbell
Title
Contact Person
Phone
(206) 453-4882

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X CG60506476 WA Primary

Addresses

Primary practice location

3214 W McGraw St
Ste 212
Seattle, WA 98199-3239

Mailing address

3214 W McGraw St
Ste 212
Seattle, WA 98199-3239

Other identifiers 1

IdentifierTypeStateIssuer
CG60506476OtherWAWASHINGTON STATE DEPARTMENT OF HEALTH

National Provider Directory

National Provider Directory
Tax ID family
Magnolia Behavior Therapy4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1424476800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1424476800000",
    "number": "1730571142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3214 W MCGRAW ST",
            "address_2": "STE 212",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981993239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3214 W MCGRAW ST",
            "address_2": "STE 212",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981993239",
            "telephone_number": "206-453-4882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGNOLIA AUTISM THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-21",
        "last_updated": "2015-02-21",
        "status": "A",
        "authorized_official_last_name": "CAMPBELL",
        "authorized_official_first_name": "MCCULLOUGH",
        "authorized_official_title_or_position": "CONTACT PERSON",
        "authorized_official_telephone_number": "206-453-4882"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "WA",
            "license": "CG60506476",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WASHINGTON STATE DEPARTMENT OF HEALTH",
            "identifier": "CG60506476",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.